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s�saso-oozo � City of Zephyrt�ills Permit Application FaX-s�saaaoo2� <br /> Buildi De artment <br /> 9 P <br /> , �" - � ' <br /> Date Received � `Phone Contact r Permittln �d — ��ZC/ <br /> Owner's Name ���2 /OdLT �10/�HQf�G� � Owner Phone Number <br /> Owner's Address �! L .SO /�' V � Owner Phone.Number - <br /> Fee Simple Tltleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# � <br /> SUBDIVISION PARCE •ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/A T Q SIGN� Q Q DEMOLISH <br /> B � INSTALL B REPAIR <br /> PROPOSED USE Q SFR �] COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK �Q FRAM Q STEEL Q <br /> DESCRIPTIOW OF WORK /�-�� � f 6� � D I�-�✓� � <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING $ VALUATIO OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVI E Q PROGRESS ENERGY � W.R.E.C. <br /> QPLUMBING $ , <br /> MECHANICAL $ � VALUATIO OF MECHANICAL INSTALLATION <br /> � <br /> QGAS Q ROOFING Q SPECII LTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOO ZONE AREA _ QYES NO <br /> BUILDER CQMPANY <br /> SIGNATURE RE ISTERED Y/ N FEE CURRE� Y/N - <br /> Address I Cicense# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CUf2RE� Y/N <br /> Addresa I • Licerise# <br /> PLUMBER C�MP.ANY <br /> SIGNATURE R GISTERED Y/ N FEE CURRE� Y/N <br /> Address License# r—. <br /> MECHANICAL COMPANY �/L � /1-t� y/ G9t��ZN L.�cz/ <br /> SIGNATURE R GISTERED Y/ N FE cu�trten Y/N <br /> Address License# <br /> ' I <br /> OTHER CQMPANY <br /> SIGNATURE REGISTERED Y/ N ; FEE CURRE� Y/N <br /> Addreas � ' I License# <br /> i <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets.of:Building'Plans;(1)se�"of Energy-Form`s;R-q-W Pertnit for new construction, . <br /> Minimum:ten(10)working"days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FacfllUes&,1..dumpste,r,,Site Work Permit for;subdivislonsAarge•projects <br /> COMMERCIAL Attach(3)complete se4s of Buildfng Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permlt for new construcdon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects:Ail commercial requlrements must meet compllance <br /> SIGN PERMIT Attach(2)sets ofEngirieered Plans..4:, , <br /> ••••PROPERTY SURVEY required for all NEW c:onst cUon. <br /> Directions: ' <br /> FIII out application completely. <br /> Owner&Contractor sign back of appifcatlon,notarized <br /> If over 52500,a Nottce of Commencemeot is required. (A/C up rades over 57500) <br /> '" Agent(for the contractor)or Power of Attomey(for'the owner)would be someone with notarized letter from owner authorizing same <br /> DVER THE COUNTER P-ERMITTING- (Front of Appllcation,Only),,..•.,,�,:;a <br /> Reroofs if shingles Sewers Servioe Upgrade"s,A%C �,. Fenc; ;(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on pub'lic'roadways.;needs ROW <br />